| NPI | 1013950641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 189936-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 17886) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-05-21 |